- Associated Press - Monday, September 13, 2010

The nation’s health system cannot be transformed by rationing medical care, President Barack Obama’s new Medicare chief said Monday in his first major speech.

Dr. Donald Berwick’s appointment earlier this summer, bypassing Senate confirmation, was contentious because some Republicans accused him of being willing to deny care to save on costs. Since then, the administration has kept Mr. Berwick out of the limelight, turning the prominent medical innovation guru into something of a mystery man in Washington.

Dr. Berwick broke his silence Monday, telling an audience of health insurance industry representatives that pushing back against unsustainable costs cannot and should not involve “withholding from us, or our neighbors, any care that helps” or “harming one hair on anyone’s head.”

The onetime Harvard researcher also said he doesn’t think federal bureaucrats have all the answers when it comes to remaking the system. “A massive, top-down, national project is not the way to do this,” he said at the conference hosted by America’s Health Insurance Plans, the industry lobbying group.


Dr. Berwick, 64, a pediatrician before entering government, has long advocated what he calls “patient-centered care,” coordination of services to provide better quality and avoid duplication and waste.

As head of Medicare and Medicaid, he oversees programs that insure more than 80 million Americans, many of them facing significant health problems. Under President Obama’s health care law, the administration wants to use Medicare and Medicaid as laboratories to test ideas on quality improvement and cost control.

Conservative critics have seized on previous comments by Dr. Berwick, such as this one from an interview last year: “The decision is not whether or not we will ration care - the decision is whether we will ration with our eyes open. And right now, we are doing it blindly.”